Is a Free Dental Exam Really Free?

Someone called my office recently to ask what a new patient exam costs. I told her $200. She said that was the highest price she had been quoted, and she was right. It was.

I want to explain why, because the comparison she was making is the one almost everybody makes, and it is the wrong one.

Down the road, another practice is advertising a deeply discounted exam, or even a free one. On paper that looks like a saving of two hundred dollars. In practice it is rarely a saving at all.

A deeply discounted exam, or even a free one, is not a price. It is an advertising spend.

Nobody is making money on that appointment. The examination, the x-rays and the clinical time all cost real money to deliver before anyone has paid the rent. So the discount is a marketing cost, and like every marketing cost it has to be recovered.

It gets recovered in the treatment plan that follows.

This is not a conspiracy, and most of the people doing it are not villains. It is simply how the arithmetic works. If you acquire a patient at a loss, that patient has to generate more revenue than they otherwise would, and the only place that revenue can come from is the treatment you are told you need.

Here is the test I would apply if I were choosing a dentist.

Do not compare the door price. Compare what you will have spent by the time your mouth is healthy.

A free exam followed by a large treatment plan costs more than a paid exam followed by a small one. That is obvious written down, and almost impossible to see when you are standing at a reception desk with a coupon in your hand.

These work on me too. If a practice will not answer them plainly, that tells you something.

At some offices the examination is largely done by an assistant and the dentist appears for a few minutes at the end. Ask who you will be sitting with, and for how long.

A thorough examination is not just a look around. It should include complete x-rays and a real diagnosis, and it takes time. “Free exam and x-rays” can mean a limited exam and two images rather than a full set, which is not the same thing at all.

This is the most useful question on the list. You cannot compare prices you have not been told, and you should never be in a chair wondering what the bill will be.

There is nothing wrong with a referral. I refer root canals to an endodontist myself, because that is who should be doing them. But you want to know in advance, rather than discovering midway through that your treatment involves three offices and three sets of fees.

At a practice with rotating associates, the person who plans your treatment may not be the person who carries it out, and may not be there next year. Ask.

I charge $200 for a comprehensive examination. That is a full hour with me, not an assistant. It includes complete x-rays, a TMJ and orthodontic evaluation which most offices do not include, and a written treatment plan with your costs before anything begins.

I do not run free or discounted new patient offers, because I would then have to recover that cost from the people who accepted it. I would rather charge honestly for the exam and have every fee after it stand on its own.

That is also why I will tell you when something can wait. A tooth that needs watching does not need treating today, and a practice that acquired you at a loss is not well placed to tell you that.

If you take nothing else from this, take the written treatment plan.

Ask for it, in writing, with costs, before treatment starts. At my office or anywhere else. It is the single thing that makes dental pricing comparable, and any practice confident in its fees will hand it to you without hesitation.

You can see how we set out costs on our dental care without insurance page, or book a comprehensive exam.

Dr. Marina Shurova is a general dentist and the owner of MyDental in Lutz, Florida. The Laker/Lutz News wrote about her single-dentist practice in “Doctor-owned practice ensures families see the same dentist.”